title: Review of the impact of NNRTI-based HIV treatment regimens on patient-reported disease burden.
abstract: While the burden of HIV disease is well documented, the value of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy regimens in reducing patient burden is not well understood. The purpose of this study was to examine patient-reported health among those receiving NNRTI-based regimens to understand their incremental value in reducing the burden of HIV. We conducted a structured literature review using PubMed to identify NNRTI trials utilizing validated patient-reported outcome (PRO) instruments during 2005-2011. The search strategy included a PubMed search to identify relevant studies based on disease, instrument, PRO, and NNRTI medication terms; and a manual search of bibliographies of identified papers. Data abstracted from each study included study type, treatment regimen(s), and PRO results. Of 11 trials identified, 8 (73%) reported significance of changes in a PRO over time and 10 (91%) reported significance of PRO changes between groups. Several domains were assessed, with significant findings (between or within groups) observed in: physical health/well-being (n = 5), emotional status/well-being (n = 2), symptoms (n = 2), anxiety (n = 2), gastrointestinal upset (n = 2), psychological health (n = 1), functional and global well-being (n = 1), fatigue/energy (n = 1), depression (n = 1), change in body appearance (n = 1), pain (n = 1), headache (n = 1), bad dreams/nightmares (n = 1), problems having sex (n = 1), and general health perception (n = 1). In conclusion, NNRTIs have been observed most frequently to improve patient-reported physical health and well-being. Treatments are needed that can also reduce patient burden in areas of emotional well-being, cognitive functioning, and overall symptom profile.
authors.affiliation: a Department of Healthcare Leadership and Management , Medical University of South Carolina , Charleston , SC , USA.
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Hanson
authors.forename: Gale
authors.initials: G
authors.lastname: Harding
authors.forename: Seema
authors.initials: S
authors.lastname: Haider
authors.forename: Margaret
authors.initials: M
authors.lastname: Tawadrous
authors.forename: Alexandra
authors.initials: A
authors.lastname: Khachatryan
authors.forename: Chris L
authors.initials: CL
authors.lastname: Pashos
authors.forename: Albert W
authors.initials: AW
authors.lastname: Wu
mesh_terms: D017281:Cost of Illness; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D018434:Sickness Impact Profile
chemical_list: D018894:Reverse Transcriptase Inhibitors